VY Advancement

Trapezoidal rotation flaps are useful for reconstructing defects of the upper nasal dorsum (Fig. 5.2a) and canthal area (Figs. 5.3-5.6). The flap geometry corresponds to a V-Y advancement, and the secondary defect is closed by mobilizing the surrounding skin (Figs. 5.2b, 5.3, and 5.4). Because these flaps receive a good blood supply from the supratrochlear artery on one side, the pedicle can be kept relatively thin, allowing for good mobilization and downward rotation of the flap.

Glabella Flap

Fig. 5.1 U-advancement flap from the glabella, used to reconstruct a defect in the superior nasal dorsum.

a Burow's triangles are located just above the eyebrows. b Appearance after closure of all defects.

Advancement Flaps Tongue

Figs. 5.3a, b and 5.4a, b Modifications of the V-Y advancement.

Fig. 5.2 a, b Trapezoidal V-Y advancement.

Fig. 5.1 U-advancement flap from the glabella, used to reconstruct a defect in the superior nasal dorsum.

a Burow's triangles are located just above the eyebrows. b Appearance after closure of all defects.

Fig. 5.2 a, b Trapezoidal V-Y advancement.

Figs. 5.3a, b and 5.4a, b Modifications of the V-Y advancement.

Fig. 5.4a, b V-Y advancement with a Z-plasty.

Fig. 5.5a, b Closure with a small transposition flap.

Fig. 5.6a, b Closure with a bilobed flap.

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